TY - JOUR
T1 - Season of radiotherapy and outcomes of head & neck cancer patients in the MACH-NC & MARCH meta-analyses
AU - Limkin, Elaine
AU - Blanchard, Pierre
AU - Lacas, Benjamin
AU - Bourhis, Jean
AU - Parmar, Mahesh
AU - Licitra, Lisa
AU - Le, Quynh Thu
AU - Yom, Sue S.
AU - Fortpied, Catherine
AU - Langendijk, Johannes
AU - Vermorken, Jan B.
AU - Bernier, Jacques
AU - Overgaard, Jens
AU - Harris, Jonathan
AU - Pignon, Jean Pierre
AU - Auperin, Anne
N1 - Publisher Copyright:
© 2023
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Background: A single institution retrospective study suggested that head and neck squamous cell cancer (HNSCC) patients receiving radiotherapy (RT) during “dark” season (fall/winter) may have better outcomes than those treated during ”light” season (spring/summer), possibly secondary to seasonal variations in cell cycle progression. We investigated the impact of season of RT in two large, multi-institutional, prospective datasets of randomized trials. Methods: Individual patient data from the MACH-NC and MARCH meta-analyses were analyzed. Dark season was defined as mid-radiotherapy date during fall or winter and light the reverse, using equinoxes to separate the two periods. Primary endpoint was progression-free survival (PFS) and secondary endpoint was locoregional failure (LRF). The effect of season was estimated with a Cox model stratified by trial and adjusted on sex, tumor site, stage, and treatment. Planned sensitivity analyses were performed on patients treated around solstices, who received “complete radiotherapy”, patients treated with concomitant radio-chemotherapy and on trials performed in Northern countries. Results: 11320 patients from 33 trials of MARCH and 6276 patients from 29 trials of MACH-NC were included. RT during dark season had no benefit on PFS in the MARCH (hazard ratio[HR]: 1.01 [95%CI 0.97;1.05],p=0.72) or MACH-NC dataset (HR:1.00 [95%CI 0.94;1.06],p=1.0. No difference in LRF was observed in the MARCH (HR:1.00 [95%CI 0.94;1.06,p=0.95) or MACH-NC dataset (HR:0.99 [95%CI 0.91; 1.07],p=0.77). Sensitivity analyses showed similar results. Conclusion: Season of RT had no impact on PFS or LRF in two large databases of HNSCC.
AB - Background: A single institution retrospective study suggested that head and neck squamous cell cancer (HNSCC) patients receiving radiotherapy (RT) during “dark” season (fall/winter) may have better outcomes than those treated during ”light” season (spring/summer), possibly secondary to seasonal variations in cell cycle progression. We investigated the impact of season of RT in two large, multi-institutional, prospective datasets of randomized trials. Methods: Individual patient data from the MACH-NC and MARCH meta-analyses were analyzed. Dark season was defined as mid-radiotherapy date during fall or winter and light the reverse, using equinoxes to separate the two periods. Primary endpoint was progression-free survival (PFS) and secondary endpoint was locoregional failure (LRF). The effect of season was estimated with a Cox model stratified by trial and adjusted on sex, tumor site, stage, and treatment. Planned sensitivity analyses were performed on patients treated around solstices, who received “complete radiotherapy”, patients treated with concomitant radio-chemotherapy and on trials performed in Northern countries. Results: 11320 patients from 33 trials of MARCH and 6276 patients from 29 trials of MACH-NC were included. RT during dark season had no benefit on PFS in the MARCH (hazard ratio[HR]: 1.01 [95%CI 0.97;1.05],p=0.72) or MACH-NC dataset (HR:1.00 [95%CI 0.94;1.06],p=1.0. No difference in LRF was observed in the MARCH (HR:1.00 [95%CI 0.94;1.06,p=0.95) or MACH-NC dataset (HR:0.99 [95%CI 0.91; 1.07],p=0.77). Sensitivity analyses showed similar results. Conclusion: Season of RT had no impact on PFS or LRF in two large databases of HNSCC.
KW - Head and neck cancer
KW - Radiation therapy
KW - Season of treatment
UR - http://www.scopus.com/inward/record.url?scp=85177769614&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2023.110011
DO - 10.1016/j.radonc.2023.110011
M3 - Article
C2 - 37956890
AN - SCOPUS:85177769614
SN - 0167-8140
VL - 190
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 110011
ER -